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Home My WebLink AboutPermit Mechanical 1985-10-31 .I"" .', '1'" . " ~~'. ,.... " ,,' ., . INSPECTION LIIIE ; 726-3769 . CITY OF SPRINGFIElD INFOrolATION liNE COMBIIIATJON APPliCATION/PERMIT 726-3753 EIIERGY SOURCES: Sq, Ftg. '.Ia i n Heat ~q. Ftg. Access. Water Heater Sq. Ftg. Other Ilew Add Al ter Pep. Range Fence_Oemo_Change/Use JI ;Y:}f);U: _Other Bu'i1ciina Permit Info: Describe Work(1-.e., Build Single Familv nesidence With Attached Garaoe) tcJ h---d~' 0 I~ VI ~ .~ ICJJ I Job Address 3,;;2. to ~./ legal De5cription Owner ~-,k rr~~,/-r"l_ Address ;P, O. ~ 1.31 pt6,[;e9't9f'c1 ~.- ---,.. p Y'7c/VO Construcitbn lender Address Ul;)lliN fl:,AH (namel Phone (address) flies. no.l (exoiresl (ohone no.) Primary Structural Electrical Mechanical CONTRACTORS (name) ~tbL--- (address) (lies. no.) (pxoirp~) (ohnnp no 1 *' Genera 1 Plumbina Electrical , ~1echanical PlUlIBING ElECTRICAl MECHANICAl NO. FH' rHARr.F NO Each single fixture Residence of 1IL..cJJAIlG.E. .llll..... SQ. FT. furnace/burner to BTU's t't'C r~ / ITempOrary Construction IChange in existing res j qftn~p Imultifamily. comm. or lnrluc:.tri<'ll IOf ICOMfl./INO. FEEOERS Ilnstall/alter/relocate I rlic:.trin fppr!prc:. .Iof amps.1 I I I I I SSUANCf OF PFR/lIT TOTAl CHARGES j TOTAl CHARGES .1 TOTAl CHARGES WHERE STATE L\\/ REQUIRES that the Electrical work be done by an. Electrical Contractor, the electrical portion of this pemit shall not be vali~ until the label has been signed by an Electrical Supervisor and returned to the Building.Division S.F. Residence (J bath I Ouplex (1 bath) IAdditional bath I ~'a ter servi ce I Sewer /Storm Sewer each !New circu~ts alts. or extens10ns , I SERVICES I I' Floor furnace and vent I Recessed wa 11 ~n~rp hp~tpr ~nrl I vpnt Relocated building (new fix. additional) amps.1 I Appl iance vent seoaratp I Stationary evap. coolar I Vent fan wi th sinole duct I Vent system apart from I heatino or A.C. I Mechanical exhaust hond and du~t )(~d~heater I- I I I I I I I I v.( 0-0 I I I Zone Fire Zone Flood Plain I HAVE CAREFUllY EXM11NED the completed aprlication for permit, and do hereby certify that all information hereon is true and correct, and I further certify that any and all work oerformed shall be done in accordance with the Ordinances of the City of Springfield and the laws of the State of Oregon pertaining to the work described herein, and that UO OCCUPAIKY will be made of any structure without the permission of the Building Division. I further certify that my re istra .on with the Builder's Board is in full force and effect as required by ons 701.055, that if exempt the basis for e 10 .s oted hereon, and that only subcontractors and employees who are in compliance with ORS 7nl.~1' ~e used on th p e 1lA/IE(please print),fJr\V; C\ M,!, ~ SIGII^TURE~\\ di~ OATE/t7~3/~ FO~ OFFICE USE bi~LY Sq, Ftg. Sq. Ftg. Sq. Ftg. Tyoe/Const, Bedrooms Stories Units Occy load Occy Group Hain Access Other x Value Value Value x x TOTAl V AlUA TI 0/1 BUIlOING PERHIT Charges anC: Surcharges Plan Ck. ___________ 65%/Bldo Plan Ck. 30%/Bldo I Fence ------------ I Oemo I Sidewalk I A/C Pavi ng --L~~---i Curb Cut Co","lInd Ppr Fpp R.es Per Fee Systems Development Charoe (1,5~) . PlUi1BING PERMIT Charges and Surcharges ElECTRICAl PERI:IT Cha rges and Surcharges MECHANICAl PERMIT Charges and Surcharges I Irotal Comb. rermit : TOTAl ~ ~s-: 6 c) .. , COMBINATION APPLICATION/PERMIT (CAP) "I. Applicant to furnish A. Job Adaress B. legal Description 1. examole- Tax lot 100, Lane County Map Reference II oj 43 Z, exa~le- Lot I. Block 3. 2nd Addition to ~prlngtield Estates C. Name. etc. of owner and construction lender O. Energy Sources 1. examele. heat/electrical ceiling/or forced air oas 2. examole- waterheater/electrlcal/or solar E. Square footage or valuation, etc. - I. examole- 1250 sq. foot house. 500 sq. foot garage 2. example- if new project. check-new - if addition, check add. etc. F. .Building permit information: 1. example - construct single family house with an attached garage 2. exa~le - remodel existing garage into family room 3. example - convert single family residence into restaurant (change of use) G. Value of work as defined in Section 303 (a) of the Structural Specialty Code H. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or job site corrections, etc. II. Abbreviated Pl~mbing, Mechanical, & Electrical Schedules A. Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant need fill-ln only the No. Boxes adjacent to the appropriate item(s) to be installed B. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division 1. To conserve space on the permit form the schedules have been abbreviated 2~ If the item(s) to be installed are not covered on the abbreviated schedules you should consult the full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D, As noted on the CAP. the label must be delivered to the electrical contractor for signature by his electrical supervisor. The general contractor is .not authorized to sign the electrical label, --- III. Applicant'to sign and date Whenever possible, the initial application will be used as a worksheet only. Where possible, Building Division Staff will prepare a type written~copy and return it to the applicant at the time the actual permit is issued for his signature. IV. Fees and Charges Plan check fees are due and payable at the time of the application, and no plans will be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued. V. FOR OFFICE. USE ONLY , PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: .. PERMIT VALIDATION I . ~ t.555i Permit Clerk~/' , /) Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name signature . I~, date .